Yoğun bakım ünitelerinde tedavi gerektiren hastalarda prognostik belirteçler: derleme

Yıl 2024, , 367 - 378, 14.10.2024

İbrahim Karagöz , Bahri Özer , Gulali Aktas

https://doi.org/10.52827/hititmedj.1443663

Öz

Yoğun bakım üniteleri, tıbbi savaşçıların en kritik hastalıklar ve yaralanmalarla mücadele ettiği ön cephe savaş alanlarıdır. Her anın yaşamla ölüm arasında gidip geldiği yoğun bakım ünitelerinin labirentinde, belirsizlik ortamında yol gösterici işaretler olarak prognostik belirteçler ortaya çıkıyor. Son yıllarda araştırmacılar yoğun bakım popülasyonunda birçok yeni mortalite belirteçleri tespit etmektedirler. Bu derlemede, yoğun bakım ünitesi popülasyonunda prognozu değerlendirmek için son yıllarda önerilen klinik ve laboratuvar belirteçlerin incelenmesi ve bu konuyla ilgili literatürün gözden geçirilmesi amaçlandı. Yoğun bakım ünitelerindeki hastaların yönetimi dinamik bir süreçtir ve bu amaçla güvenilir risk sınıflandırma modellerine ve prognostik belirteçlere ihtiyaç vardır. Yeni prognostik göstergeler, kritik hastalarda güvenilir tanı ve prognostik araçlar olarak hizmet edebilir.

Anahtar Kelimeler

belirteç, mortalite, öngördürücü, prognoz, yoğun bakım

The predictors of outcome in patients that require management in intensive care units: A narrative review

Öz

Intensive care units stand as the frontline battlegrounds where medical warriors combat the most critical illnesses and injuries. Within the labyrinth of intensive care units, where every moment teeters between life and death, prognostic markers emerge as beacons of guidance amidst uncertainty. In recent years, researchers have identified several novel mortality predictors in the intensive care population. In this review, we aimed to examine the clinical and laboratory markers that have been proposed in recent years to evaluate prognosis in the intensive care unit population and to review the literature on this topic. Management of patients in intensive care units is a dynamic process and reliable risk stratification models and prognostic markers are needed for this purpose. Novel prognostic indicators could serve as reliable diagnostic and prognostic tools in critically ill patients.

Anahtar Kelimeler

intensive care, marker, mortality, predictor, prognosis

Kaynakça

• Greenberg SM, Ziai WC, Cordonnier C, et al. 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association. Stroke. 2022;53(7):e282-e361.
• Wazir H, Abid M, Essani B, et al. Diagnosis and Treatment of Liver Disease: Current Trends and Future Directions. Cureus. 2023;15(12):e499-e522.
• Jentzer JC, Kashou AH, Murphree DH. Clinical applications of artificial intelligence and machine learning in the modern cardiac intensive care unit. Intelligence Based Medicine. 2023 ;7(1):89-100.
• Garduno A, Cusack R, Leone M, Einav S, Martin-Loeches I. Multi-Omics Endotypes in ICU Sepsis Induced Immunosuppression. Microorganisms. 2023;11(5): 11-19.
• Delahanty RJ, Kaufman D, Jones SS. Development and Evaluation of an Automated Machine Learning Algorithm for In-Hospital Mortality Risk Adjustment Among Critical Care Patients. Critical Care Medicine. 2018;46(6):e481-e488.
• Johnson AE, Ghassemi MM, Nemati S, et al. Machine Learning and Decision Support in Critical Care. Proceedings of the Institute of Electrical and Electronics Engineers. 2016;104(2):444-466.
• Koyner JL, Carey KA, Edelson DP, Churpek MM. The Development of a Machine Learning Inpatient Acute Kidney Injury Prediction Model. Critical Care Medicine. 2018;46(7):1070-1077.
• Houthooft R, Ruyssinck J, van der Herten J, et al. Predictive modelling of survival and length of stay in critically ill patients using sequential organ failure scores. Artificial Intelligence in Medicine. 2015;63(3):191-207.
• Jafari M, Fazeli F, Sezavar M, et al. Role of Procalcitonin in the Prognosis of Mortality in Patients Admitted to the Intensive Care Unit: A Review Study. Tanaffos. 2021;20(4):296-305.
• Martino M, Arnaldi G. Copeptin and stress. Endocrines. 2021;2(4):384-404.
• François B, Lambden S, Fivez T, et al. Prospective evaluation of the efficacy, safety, and optimal biomarker enrichment strategy for nangibotide, a TREM-1 inhibitor, in patients with septic shock (ASTONISH): a double-blind, randomised, controlled, phase 2b trial. Lancet Respirtory Medicine. 2023;11(10):894-904.
• Hernandez-Beeftink T, Guillen-Guio B, Lorenzo-Salazar JM, et al. A genome-wide association study of survival in patients with sepsis. Critical Care. 2022;26(1):341-346.
• Hamilton FW, Thomas M, Arnold D, et al. Therapeutic potential of IL6R blockade for the treatment of sepsis and sepsis-related death: A Mendelian randomisation study. Public Library of Science Medicine. 2023;20(1):41-74.
• Guillen-Guio B, Lorenzo-Salazar JM, Ma SF, et al. Sepsis-associated acute respiratory distress syndrome in individuals of European ancestry: a genome-wide association study. Lancet Respirtory Medicine. 2020;8(3):258-266.
• Liao SY, Casanova NG, Bime C, et al. Identification of early and intermediate biomarkers for ARDS mortality by multi-omic approaches. Scientific Reports. 2021;11(1):74-88.
• Maheshwari K, Nathanson BH, Munson SH, et al. Abnormal shock index exposure and clinical outcomes among critically ill patients: A retrospective cohort analysis. Journal of Critical Care. 2020;57:5-12.
• Sauthier M, Tuli G, Jouvet PA, et al: A Continuous and Noninvasive Method to Estimate Pao(2) and Oxygenation Index. Crit Care Explorations. 2021;3(10):40-46.
• Pölkki A, Pekkarinen PT, Takala J, et al. Association of Sequential Organ Failure Assessment (SOFA) components with mortality. Acta anaesthesiologica Scandinavica. 2022;66(6):731-741.
• Deasy J, Liò P, Ercole A. Dynamic survival prediction in intensive care units from heterogeneous time series without the need for variable selection or curation. Scientific Reports. 2020;10(1):221-229.
• Tian Y, Yao Y, Zhou J, et al. Dynamic APACHE II Score to Predict the Outcome of Intensive Care Unit Patients. Frontiers in Medicine. 2021;8:744-749.
• Gregoriano C, Heilmann E, Molitor A, et al. Role of procalcitonin use in the management of sepsis. Journal of thoracic disease. 2020;12(1):5-15.
• Webb AL, Kramer N, Stead TG, et al. Serum Procalcitonin Level Is Associated with Positive Blood Cultures, In-hospital Mortality, and Septic Shock in Emergency Department Sepsis Patients. Cureus. 2020;12(4):78-82.
• Schuetz P. How to best use procalcitonin to diagnose infections and manage antibiotic treatment. Clinical Chemistry and Laboratory Medicine. 2023;61(5):822-828.
• Bilgin S, Kurtkulagi O, Atak Tel BM, et al. Does C-reactive protein to serum Albumin Ratio correlate with diabEtic nephropathy in patients with Type 2 dIabetes MEllitus? The CARE TIME study. Primary Care Diabetes. 2021;15(6):1071-1074.
• Demirkol ME, Aktas G. C‐reactive protein to LymphocytE count ratio could be a reliable mArkeR of thyroiditis; the CLEAR‐T study. Precision Medical Sciences. 2022;11(1):31-34.
• Aktas G. Serum C-Reactive Protein to Albumin Ratio as a Reliable Marker of Diabetic Neuropathy in Type 2 Diabetes Mellitus. Biomolecules and biomedicine. 2024.
• Demirkol ME, Aktas G, Bilgin S, et al. C-reactive protein to lymphocyte count ratio is a promising novel marker in hepatitis C infection: the clear hep-c study. Revista da Associação Médica Brasileira. 2022;68(6):838-841.
• Demirkol ME, Bilgin S, Kahveci G, et al. La proporcion de proteina C reactiva a linfocitoE es un marcador confiable en pacientes con infeccion por COVID-19; el estudio CLEAR COVID. Cirugia Y Cirujanos. 2022;90(5):596-601.
• Karagoz I, Ozer B, Ital I, et al. C-reactive protein-to-serum albumin ratio as a marker of prognosis in adult intensive care population. Bratislava medical journal. 2023;124(4):277-279.
• Li X, Yang Y, Zhang B, et al. Lactate metabolism in human health and disease. Signal Transduction and Targeted Therapy. 2022;7(1):305.
• Park IH, Yang JH, Jang WJ, et al. Clinical significance of lactate clearance in patients with cardiogenic shock: results from the RESCUE registry. Journal of Intensive Care. 2021;9(1):63-66.
• Kabra R, Acharya S, Kumar S. Serum lactate levels in critically Ill patients: An early marker to be targeted. Journal of the Scientific Society. 2022;49(3):246-250.
• Muthukumar V, Arumugam PK, Narasimhan A, et al. Blood Lactate And Lactate Clearance: Refined Biomarker And Prognostic Marker In Burn Resuscitation. Annals of Burns Fire Disasters. 2020;33(4):293-298.
• Larcher R, Besnard N, Akouz A, et al. Admission High-Sensitive Cardiac Troponin T Level Increase Is Independently Associated with Higher Mortality in Critically Ill Patients with COVID-19: A Multicenter Study. Journal of Clinical Medicine. 2021;10(8):12-20
• Jayasimhan D, Foster S, Chang CL, et al. Cardiac biomarkers in acute respiratory distress syndrome: a systematic review and meta-analysis. Journal of Intensive Care. 2021;9(1):36-40
• Van der Slikke EC, Star BS, de Jager VD, et al. A high urea-to-creatinine ratio predicts long-term mortality independent of acute kidney injury among patients hospitalized with an infection. Scientific Reports. 2020;10(1):149-156.
• Li X, Zheng R, Zhang T, et al. Association between blood urea nitrogen and 30-day mortality in patients with sepsis: a retrospective analysis. Annals of Palliative Medicine. 2021;10(11):11653-11663.
• Arnaldez FI, O'Day SJ, Drake CG, et al. The Society for Immunotherapy of Cancer perspective on regulation of interleukin-6 signaling in COVID-19-related systemic inflammatory response. Journal of Immunother Cancer. 2020;8(1):12-16
• Yan Y, Hu Y, Wang X, et al. The predictive prognostic values of serum interleukin-2, interleukin-6, interleukin-8, tumor necrosis factor-α, and procalcitonin in surgical intensive care unit patients. Annals of Translational Medicine. 2021;9(1):56-60
• Dhar SK, K V, Damodar S, et al. IL-6 and IL-10 as predictors of disease severity in COVID-19 patients: results from meta-analysis and regression. Heliyon. 2021;7(2):55-61.
• Battaglini D, Robba C, Fedele A, et al. The Role of Dysbiosis in Critically Ill Patients With COVID-19 and Acute Respiratory Distress Syndrome. Frontiers Medicine . 2021;8(1):671-714.
• Guirao JJ, Cabrera CM, Jiménez N, et al. High serum IL-6 values increase the risk of mortality and the severity of pneumonia in patients diagnosed with COVID-19. Molecular Immunology. 2020;128:64-68.
• Lavillegrand JR, Garnier M, Spaeth A, et al. Elevated plasma IL-6 and CRP levels are associated with adverse clinical outcomes and death in critically ill SARS-CoV-2 patients: inflammatory response of SARS-CoV-2 patients. Annals of Intensive Care. 2021;11(1):9-12.
• McElvaney OJ, Curley GF, Rose-John S, et al. Interleukin-6: obstacles to targeting a complex cytokine in critical illness. Lancet Respirotory Medicine. 2021;9(6):643-654.
• Cambier S, Gouwy M, Proost P. The chemokines CXCL8 and CXCL12: molecular and functional properties, role in disease and efforts towards pharmacological intervention. Cellular and Molecular Immunology. 2023;20(3):217-251.
• Hu Q, Hao C, Tang S. From sepsis to acute respiratory distress syndrome (ARDS): emerging preventive strategies based on molecular and genetic researches. Bioscience Reports. 2020;40(5):1-9
• Bülow Anderberg S, Luther T, Berglund M, et al. Increased levels of plasma cytokines and correlations to organ failure and 30-day mortality in critically ill Covid-19 patients. Cytokine. 2021;138:83-89.
• Ishikawa S, Teshima Y, Otsubo H, et al. Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients. BioMed Central Emergency Medicine. 2021;21(1):132-142
• Cutuli SL, Carelli S, Grieco DL, De Pascale G. Immune Modulation in Critically Ill Septic Patients. Medicina (Kaunas). 2021;57(6):552-563
• Fatani SH, Alkhatib KH, Badr H, et al. Association of TNF-α-308 (G >A) (rs1800629) Gene Polymorphism with Adverse Outcomes of Sepsis in Critically Ill Patients. DNA and Cell Biology. 2020;39(9):1723-1729.
• Ilias I, Vassiliou AG, Keskinidou C, et al. Changes in Cortisol Secretion and Corticosteroid Receptors in COVID-19 and Non COVID-19 Critically Ill Patients with Sepsis/Septic Shock and Scope for Treatment. Biomedicines. 2023;11(7):1801-1806
• Gharamti AA, Samara O, Monzon A, et al. Proinflammatory cytokines levels in sepsis and healthy volunteers, and tumor necrosis factor-alpha associated sepsis mortality: A systematic review and meta-analysis. Cytokine. 2022;158:156-167.
• Medina-Leyte DJ, Zepeda-García O, Domínguez-Pérez M, et al. Endothelial Dysfunction, Inflammation and Coronary Artery Disease: Potential Biomarkers and Promising Therapeutical Approaches. International Journal of Moleculer Sciences. 2021;22(8).
• Yang YL, Wu CH, Hsu PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. European Journal of Clinical Investigation. 2020;50(5):132-140.
• Fois AG, Paliogiannis P, Scano V, et al. The Systemic Inflammation Index on Admission Predicts In-Hospital Mortality in COVID-19 Patients. Molecules. 2020;25(23):5725-5736
• Taslamacioglu Duman T, Ozkul FN, Balci B. Could Systemic Inflammatory Index Predict Diabetic Kidney Injury in Type 2 Diabetes Mellitus? Diagnostics (Basel). 2023;13(12):2063-2074
• Tian M, Li Y, Wang X, et al. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score Is Associated With Poor Outcome of Acute Ischemic Stroke. Frontiers Neurology. 2020;11:610-618.
• Antar R, Farag C, Xu V, et al. Evaluating the baseline hemoglobin, albumin, lymphocyte, and platelet (HALP) score in the United States adult population and comorbidities: an analysis of the NHANES. Frontiers in Nutrition. 2023;10:120-134.
• Xu H, Zheng X, Ai J, Yang L. Hemoglobin, albumin, lymphocyte, and platelet (HALP) score and cancer prognosis: A systematic review and meta-analysis of 13,110 patients. International Immunopharmacology. 2023;114(1):1094-1099.
• Manal M, Naglaa M, Kareem MF, et al. Anemia in Critically Ill Patients; Prevalence and Prognostic Implications. The Medical Journal of Cairo University. 2020;88(12):2121-2129.
• Eckart A, Struja T, Kutz A, et al. Relationship of Nutritional Status, Inflammation, and Serum Albumin Levels During Acute Illness: A Prospective Study. The American Journal of Medicine. 2020;133(6):713-722.
• Cai L, Zhou X, Wang M, et al. Predictive Nomogram for Severe COVID-19 and Identification of Mortality-Related Immune Features. The Journal of Allergy and Clinical Immunology in Practice. 2021;9(1):177-184.
• Santoshi RK, Patel R, Patel NS, et al. A Comprehensive Review of Thrombocytopenia With a Spotlight on Intensive Care Patients. Cureus. 2022;14(8):27718-27729.
• Amgalan A, Othman M. Hemostatic laboratory derangements in COVID-19 with a focus on platelet count. Platelets. 2020;31(6):740-745.
• Aktas G, Khalid A, Kurtkulagi O, et al. Poorly controlled hypertension is associated with elevated serum uric acid to HDL-cholesterol ratio: a cross-sectional cohort study. Postgraduate Medicine. 2022;134(3):297-302.
• Kosekli MA, Kurtkulagii O, Kahveci G, et al. The association between serum uric acid to high density lipoprotein-cholesterol ratio and non-alcoholic fatty liver disease: the abund study. Revista Associaçao Medica Brasileira (1992). 2021;67(4):549-554.
• Aktas G, Kocak MZ, Bilgin S, et al. Uric acid to HDL cholesterol ratio is a strong predictor of diabetic control in men with type 2 diabetes mellitus. Aging Male. 2020;23(5):1098-1102.
• Kurtkulagi O, Tel BMA, Kahveci G, et al. Hashimoto's thyroiditis is associated with elevated serum uric acid to high density lipoprotein-cholesterol ratio. Romanian Journal of Internal Medicine. 2021;59(4):403-408.
• Kocak MZ, Aktas G, Erkus E, et al. Serum uric acid to HDL-cholesterol ratio is a strong predictor of metabolic syndrome in type 2 diabetes mellitus. Revista Associaçao Medica Brasileira (1992). 2019;65(1):9-15.
• Aktas G, Yilmaz S, Kantarci DB, et al. Is serum uric acid-to-HDL cholesterol ratio elevation associated with diabetic kidney injury? Postgraduate Medicine. 2023;135(5):519-523.
• Hu X, Liu J, Li W, et al. Elevated serum uric acid was associated with pre-inflammatory state and impacted the role of HDL-C on carotid atherosclerosis. Nutrition ,Metabolism and Cardiovasculer Diseases. 2022;32(7):1661-1669.
• Montero-Chacón LB, Padilla-Cuadra JI, Chiou SH, et al. High-Density Lipoprotein, Mean Platelet Volume, and Uric Acid as Biomarkers for Outcomes in Patients With Sepsis: An Observational Study. Journal of Intensive Care Medicine. 2020;35(7):636-642.
• Aktas G. Association between the Prognostic Nutritional Index and Chronic Microvascular Complications in Patients with Type 2 Diabetes Mellitus. Journal of Clinical Medicine. 2023;12(18):52-59
• Sheinenzon A, Shehadeh M, Michelis R, et al. Serum albumin levels and inflammation. International Journal of Biological Macromolecules. 2021;184:857-862.
• Noack M, Miossec P. Importance of lymphocyte-stromal cell interactions in autoimmune and inflammatory rheumatic diseases. Nature Reviews Rheumatology. 2021;17(9):550-564.
• Wang Z, Zhao L, He S. Prognostic nutritional index and the risk of mortality in patients with hypertrophic cardiomyopathy. International Journal of Cardiology. 2021;331:152-157.
• Mulazzani GEG, Corti F, Della Valle S, et al. Nutritional Support Indications in Gastroesophageal Cancer Patients: From Perioperative to Palliative Systemic Therapy. A Comprehensive Review of the Last Decade. Nutrients. 2021;13(8):2766-2777
• Aktas G, Alcelik A, Tekce BK, et al. Red cell distribution width and mean platelet volume in patients with irritable bowel syndrome. Gastroenterology Review/Przegląd Gastroenterologiczny. 2014;9(3):160-163.
• Aktas G, Sit M, Dikbas O, et al. Could red cell distribution width be a marker in Hashimoto’s thyroiditis? Experimental and Clinical Endocrinology & Diabetes. 2014;122(10):572-574.
• Cakır L, Aktas G, Mercimek OB, et al. Are red cell distribution width and mean platelet volume associated with rheumatoid arthritis. Biomedical Research. 2016;27(2):292-294.
• Aktas G, Sit M, Karagoz I, et al. Could Red Cell Distribution Width be a Marker of Thyroid Cancer? Journal of College Physicians Surgeons Pakistan. 2017;27(9):556-558.
• Duman TT, Aktas G, Atak B, et al. Is mean platelet volume to platelet ratio a promising indicator of diabetic regulation in type 2 diabetes mellitus. The Journal of Medical Research. 2018;4(3):137-139.
• Kocak MZ, Aktas G, Erkus E, et al. Mean Platelet Volume to Lymphocyte Ratio as a Novel Marker for Diabetic Nephropathy. Journal of College Physicians Surgeons Pakistan. 2018;28(11):844-847.
• Bilgin S, Tel BMA, Kahveci G, et al. Hypothyroidism is strongly correlated with mean platelet volume and red cell distribution width. National Journal of Health Sciences. 2021;6(1):7-10.
• Aktas G, Sit M, Tekce H, et al. Mean platelet volume in nasal polyps. West Indian Medical Journal. 2013;62(6):515-518.
• Karagoz I, Aktas G, Yoldas H, et al. Association Between Hemogram Parameters and Survival of Critically Ill Patients. Journal of Intensive Care Medicine. 2019;34(6):511-513.
• Liberski PS, Szewczyk M, Krzych Ł J. Haemogram-Derived Indices for Screening and Prognostication in Critically Ill Septic Shock Patients: A Case-Control Study. Diagnostics (Basel). 2020;10(9):638-647
• Velazquez S, Madurga R, Castellano JM, et al. Hemogram-derived ratios as prognostic markers of ICU admission in COVID-19. BioMed Central Emergency Medicine. 2021;21(1):1-9.